Focus on Patients, Not Paperwork with our professional credentialing services!

Provider Credentialing can be a stressful and complex process. We have the experience to get things done quickly and efficiently. Let us take on the insurance companies while you take on the day!

All medical workers must understand that practicing medicine is a privilege. That means, first and foremost, getting credentialed. This privilege is why every medical practitioner needs the services of a competent and experienced medical credentialer. Credentialing Concepts is here to assist you with all of your professional credential service needs. Are you positioned for success?

Credentialing Concepts provides professional credential services in a multitude of areas. We hold pride in our company, our abilities and highly value integrity and trust. We want all of our clients to rest easy, knowing that we will always perform to the level you deserve and can count on throughout the process. Our team and resources offer better customer service and an intense focus on helping you revolutionize your healthcare organization for imminent benefit.

Credentialing concepts can also help your organization with CAHQ credentialing! CAQH credentialing is also a beneficial tool that we can help you navigate. CAQH is an online data repository of credentialing data. Practitioners can self-report demographics, education and training, work history, malpractice history, and other relevant credentialing information for insurance companies to access. Inputting this data can be time-consuming for a practicing physician. Save time and money by utilizing our medical credentialing services!

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Provider Services

We know dealing with insurance companies can be a difficult task. From established providers to start-ups, we are here to make your life easier.

Patient Debt Collection

We can provide a full comprehensive review of outstanding patient balances to provide a goal and feasible suggestions to increase revenue.

Quality Medical Credentialing Through Dedication

Provider credentialing is a process of vetting a doctor’s competence, training, and practice history. This process is necessary to protect your organization and patients. Professional credentialing services will benefit your medical organization in several ways. The credentialing process begins with the physician’s application. The process must include details of when and where the doctor practiced, held licensing, as well as full name, educational history, and any diplomas or certifications. Potential employers or payers review and verify this information, checking with the respective schools, accreditation with the appropriate boards, and ethical complaints with each state. The investigation results determine whether the organization should hire the physician, or in the case of a payer, will permit the physician to bill that insurance carrier.

Larger hospitals and organizations usually have a dedicated staff that works specifically on credentialing services for currently employed practitioners and applicants coming on board. Smaller organizations may find it beneficial to obtain an outside service. Insurance credentialing is time-consuming and tedious. Outsourcing this process, especially for smaller organizations, may free up staff to continue with their regular day-to-day duties, making office personnel free to follow through with assignments with less pressure concerning making mistakes. The healthcare industry is rapidly changing, which means new, complex technology to learn and navigate. Credentialing Concepts is here to help! We are like acetaminophen for the headache your office manager gets from paperwork. When mistakes occur during the insurance credentialing process, it can delay practitioners’ getting paid by insurance providers or cause them to lose hospital privileges when deadlines lapse. Credentialing Concepts can provide this service for organizations, both large and small.



Professional Credentialing Services

Save time, and let us do the paperwork for you! The utilization of third-party, professional credential services allows you to spend more time with patients and less time shuffling papers. We provide significant medical provider enrollment, Medicare, and Medicaid enrollments for groups and individuals, allowing payments from third-party payers to arrive much quicker. Having a knowledgeable and professional credential service may make hiring medical staff faster and more efficient. A credential service provider expands the healthcare worker’s network resulting in a larger market and more significant revenue. The more payers that an organization is affiliated with, the greater the patient base that your facility and staff can benefit from that revenue. Your organization can’t bill for the services a practitioner provides unless all payers have approved that professional through the credentialing process. Payor enrollment makes medical provider credentialing a foundational task. When an organization providing services cannot bill payers because the proper credentialing fails completion, it isn’t feasible for the professional or organization. It may also open up the organization and practitioner to risk and liability issues.

Although credentialing can be time-consuming, it is an absolute necessity to onboard new providers. Have you considered using a credential service provider? The benefits outweigh the risk in every single case. The medical credentialing process ensures that the provider meets both the organization and the payers’ standards. Professional credentialing services can identify risk factors early and reduce adverse outcomes. As a result, this process improves the patient’s trust in their provider and practice, protects revenues, limits the risk of potential loss, and improves its reputation. If a staff member makes a mistake or deadlines are not met, it can cause a revenue loss or put your practice at a standstill until the credentialing process is complete. It is paramount for an organization to be compliant and up to date. Your organization is less likely to be impacted negatively or lose revenue by staying current with renewing credentials or credentialing for a new insurer.

Whether primary care or specialty, multi-site or solo practitioner, hundreds of physicians and allied health professionals trust Credentialing Concepts every day to maximize their revenue and improve the way they deliver effective, coordinated care for physician credentialingInsurance credentialing can take up to 120 days. Credentialing Concepts has a dedicated, experienced, and professional staff with insight and contact databases that may provide a quicker turnaround time for professional credentialing services.

Why Choose Us

Large or small; old or new, we are here for each of our clients as if they are our only client. From start to finish, Credentialing Concepts’ main focus is robust credentialing your organization. With customer support and attentive follow-up, our staff will get the requested credentialing completed as quickly as possible


Reduce the Burden of Paperwork

Have you considered using a credential service provider? The benefits outweigh the risk in every single case. The utilization of third-party, professional credential services allows you to spend more time with patients and less time shuffling papers.
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Enhance the Profitability of Your Healthcare Organization

Hundreds of physicians and allied health professionals trust us every day to maximize their revenue and improve the way they deliver effective coordinated care. Let us help you expand your network, resulting in a larger market and more significant revenue.
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Stay Compliant

Requirements for credentialing are ever-changing. It is essential to stay up to date to ensure privileges are maintained. Credentialing Concepts is here to assist you with all of your professional credential service needs. Are you positioned for success?
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